Theodore Scott    Powers    MD
Contract Details
Workfirst Occupational Health Center
Facility name
Provider ID
P000001393
NPI
1851320501
Tax ID
631058174
Effective Date
8/9/2000
Last Updated
5/6/2014
Direct Contract
Yes
Term Date
5/6/2014
Status
Contract Discounts
Discount Type
F
Fee Schedule Name
103.00
Fee Schedule Multiplier
Location Details
Address
909 Graham Street Suite C
Cullman, AL 35055
United States
County
Cullman
Phone
2567377774 (Phone)
Billing Details
Address
P.O. Box 867
Cullman, AL 35056
Billing Phone
2567377774
Specialty Type
Physical Medicine & Rehabilitation
Map
Address